97802

Medical Nutrition Therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes

CPT code 97802 represents the initial medical nutrition therapy (MNT) assessment and intervention provided to an individual patient in a face-to-face encounter. This service is performed by a registered dietitian or nutrition professional and involves a comprehensive evaluation of the patient's nutritional status, dietary intake, lifestyle, and health goals. The intervention component includes developing and implementing a personalized nutrition care plan, providing nutrition education, counseling, and guidance to manage specific diseases or conditions. This code is billed in 15-minute increments, meaning that for every 15 minutes spent on the initial assessment and intervention, one unit of 97802 can be reported. For example, a 45-minute session would be reported with 3 units of 97802.

Clinical Indications

  • Type 1 and Type 2 Diabetes Mellitus
  • Gestational Diabetes
  • Chronic Kidney Disease (stages 3, 4, 5, or post-transplant)
  • Obesity (Body Mass Index greater than or equal to 30 kg/m²)
  • Cardiovascular diseases (e.g., hyperlipidemia, hypertension, congestive heart failure)
  • Gastrointestinal disorders (e.g., Crohn's disease, ulcerative colitis, celiac disease, irritable bowel syndrome)
  • Eating disorders (e.g., anorexia nervosa, bulimia nervosa)
  • Oncology/Cancer treatment support
  • Malnutrition or unintentional weight loss/gain
  • Food allergies or intolerances
  • Pre- and post-bariatric surgery nutrition counseling

Procedure Steps

  1. Review patient's medical history, lab results, and current medications.
  2. Conduct a comprehensive nutritional assessment, including dietary intake, eating patterns, physical activity, and lifestyle factors.
  3. Assess anthropometric measurements (e.g., height, weight, BMI) and relevant clinical data.
  4. Establish a nutritional diagnosis based on the assessment findings.
  5. Collaborate with the patient to define specific, measurable, achievable, relevant, and time-bound (SMART) nutrition goals.
  6. Develop and implement an individualized nutrition intervention plan tailored to the patient's condition and goals.
  7. Provide nutrition education and counseling on appropriate food choices, portion control, meal planning, and behavior modification strategies.
  8. Document all aspects of the assessment, intervention, education, and patient progress in the medical record.

Coding Guidelines

  • Code 97802 is reported for the initial individual medical nutrition therapy assessment and intervention. Subsequent individual MNT sessions are reported with CPT code 97803.
  • This code is billed in 15-minute increments. Document the total face-to-face time spent with the patient to justify the number of units billed.
  • Only qualified nutrition professionals (e.g., Registered Dietitian Nutritionists RDNs) are eligible to provide and bill for MNT services.
  • MNT services require a referral from a physician or other qualified healthcare professional stating the diagnosis that necessitates the MNT.
  • Documentation must include a clear nutritional assessment, diagnosis, intervention plan, goals, and patient response.
  • When MNT services are provided on the same day as other services by the same provider, ensure that the MNT is a distinct service, separate from other services, and if appropriate, use modifier 59.
  • Medicare and many private payers limit the number of MNT sessions covered per calendar year, typically for specific diagnoses like diabetes and renal disease. Verify coverage policies.
  • Group MNT is reported with CPT code 97804.

Associated ICD-10 Codes